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A Handoff Protocol for Pediatric Trauma Patients at a Rural Level One Trauma Center Reduces Length of Stay
Ist Teil von
The American surgeon, 2021-06, Vol.87 (6), p.979-981
Ort / Verlag
Los Angeles, CA: SAGE Publications
Erscheinungsjahr
2021
Link zum Volltext
Quelle
Alma/SFX Local Collection
Beschreibungen/Notizen
Background
The management of the pediatric trauma patient is variable among trauma centers. In some institutions, the trauma surgeon maintains control of the patient throughout the hospital stay, while others transfer to a pediatric specialist after the initial evaluation and resuscitation period. We hypothesized that handoff to the pediatric surgeon would decrease the length of stay by more efficient coordination with pediatric subspecialists and ancillary staff.
Methods
A retrospective review from October 2014 to October 2018 was conducted at our rural level 1 trauma center analyzing the length of stay across all demographics and trauma triage levels before and after institution of a handoff protocol from adult specialized trauma surgeons to pediatric surgeons within a 24-hour window. Further analysis included emergency department (ED) disposition to include the effect of handoff on the length of stay in the setting of a higher post-ED acuity, that is, disposition of monitored beds.
Results
1267 patient charts were analyzed and the mean length of stay was reduced by .38 days (t = 5.92, P < .0005) across all demographics, trauma triage levels, post-ED dispositions, and mechanisms of injury after institution of our handoff protocol.
Conclusion
Handoff from adult specialized trauma surgeons to pediatric surgeons within a 24-hour window at a rural level 1 trauma center significantly improved the length of stay by .38 (t = 5.92, P < .0005) among pediatric trauma patients in all demographics, trauma triage activations levels, mechanisms of injury, and post-ED dispositions acuity levels.